Breaking the Cycle

It's expensive and time-consuming, but a court can help cure the hard-core homeless problem in San Francisco

That was Winters' welcome to his new home, where he'd stay for the next 20 years. He got his monthly Social Security check delivered to the post office — Winters is considered both mentally and physically disabled, on account of his bad eye and a bad leg from getting hit by a car in Atlanta. He became the typical San Francisco street guy, occasionally getting a room in the Tenderloin for a few days, but mostly sleeping in Golden Gate Park or at shelters, he says. "Lot of times I'd blow my money on girls and weed," he says.

The police incident reports tell Winters' tale from there on, with a steady drumbeat of arrests. (Police records from before 1990 were purged, so Winters' rap sheet runs from 1990 to 2003.) Some of the crimes were as petty as it gets — like a 1991 arrest for breaking into an Alcoholics Anonymous meeting hall and stealing $5. Others have an edge of violence to them, like another arrest that same year for lighting matches in a Tenderloin building and dropping them on the floor.

By 1996, he had adopted the Inner Sunset as his neighborhood, and hung out at Ninth Avenue and Irving Street to sell copies of Street Sheet, the newspapers printed by the Coalition on Homelessness. Over the next eight years, he proceeded to thoroughly wear out his welcome. Police reports show that he harassed passersby, and for a while in 1999 he made a habit of slapping people in the back of the head (he was arrested for battery). By 2001, merchants were complaining that someone was routinely tipping over trash cans on the sidewalk; when the police staked out the corner, they saw Winters methodically roll each can to the doorway of a store before dumping it.

Winters was arrested for public nuisance in that instance, but was out of jail again probably within 12 hours. The trouble continued — store owners came to work to find their windows coated in cooking oil, and neighbors complained of public defecation and Winters' "erratic behavior and threatening manner." A judge issued the stay-away order to keep Winters from troubling the merchants at Ninth and Irving, but in March 2003, he was arrested at that corner on two subsequent days.

Winters downplays the constant trouble he was in, either out of embarrassment or because he sincerely doesn't remember; his case worker notes that he has very little insight into his mental illness and its effects. "I guess I wasn't the best neighbor in the Sunset; they had their problems with me," says Winters. "I guess they got tired of a bum, basically."

So what happened to Winters after each of those arrests? According to Jo Robinson, the director of Jail Psychiatric Services, he likely received a psychiatric evaluation almost every time he was brought in. Certainly in the last few years of Winters' time as a vagrant, the jail psychiatrists got very familiar with him. According to Winters' case manager, he was evaluated in jail 18 times between April 2002 and March 2003.

But Winters' petty crimes kept him in jail for a couple of days at most. And, like many others who cycle endlessly through the Hall of Justice, he appeared to prefer an unmedicated life on the street to anything the psychiatrists were offering. "We try to get them into services, but a lot of them don't want services," says Robinson. "We'll talk to them each time we see them. We'll ask them, "How about this time? Are you ready?'"

Robinson says that 11 percent of the jail population has a serious mental illness like schizophrenia or bipolar disorder, and almost 25 percent of the population is on some psychotropic medication (which includes commonly prescribed drugs like antidepressants). According to a spokeswoman for the sheriff's department, the San Francisco jail is the biggest provider of mental health services in the city.

The three psychiatric units are as therapeutic as the staff can make them. The inmates can hang out in "socialization areas" during the day, playing checkers or chess at picnic tables. They can attend individual and group therapy sessions, or try art therapy or yoga. They even have periodic celebrations for the inmates — a party in June featured puppet shows and karaoke.

While Robinson makes the inmates sound like kids at a day camp, she says the image that the outside world has of her clients is quite different. "I still think there's a stigma attached to mentally ill people who come through the jail," says Robinson. She believes they're no different than mentally ill people who come to treatment through the hospital, or through private doctors. "They're the same people — it just depends on what door they come in," she says. "There's this idea that they're all horribly violent. But it's due to their mental illness that they've committed some crime."

The crime that eventually got Winters into court and into treatment was most likely the result of a paranoid fantasy, but Winters doesn't remember what it was. "They said I tried to wreck the Muni train, but they were exaggerating a little bit," Winters says. "I guess I threw a steel rod pretty much right in front of it. I don't know why I did that," he says, with a genuinely puzzled air.

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